Do Statins Decrease Or Increase The Risk Of Parkinson’s Disease?

The Fine Print Behind The Misleading Headline

Author: Dr. Stephen Chaney

I hadn’t paid much attention to the headlines saying “Statin Use May Decrease Parkinson’s Risk” until the other day when I happened to glance a couple of lines below the headline and spotted a statement saying “Study Shows That Discontinuation of Statin Therapy Increases Risk of Parkinson’s”.

I immediately said to myself “That’s bizarre. There is a total disconnect between the headlines and the study.” If you really wanted to determine whether statin use reduced the risk of Parkinson’s, you would compare the incidence of Parkinson’s disease in a group of statin users and a matched group who did not use statins.

It turns out those studies have been done, and they were inconclusive – some studies showed a slight increase in Parkinson’s in statin users, some showed a slight decrease, and most showed no correlation between statinuse and Parkinson’s.

In that context, this study could equally well have been interpreted as suggesting that statin use increased the risk of Parkinson’s, but somehow none of the headlines mentioned that possibility.

Are Both Possibilities Plausible?

Let’s look at each possibility in detail. The reasoning is complex, but let me try to walk you through it.

Could Statins Decrease The Risk Of Parkinson’s

Parkinson’s is caused by the progressive degeneration of the brain neurons that produce a chemical messenger called dopamine that controls muscle movement. However, the causes of nerve degeneration in Parkinson’s patients are largely unknown.

Genetics may play a small role. Environmental toxins may play a role. But most experts feel that Parkinson’s patients produce an excess of free radicals, and it is the oxidative damage caused by those free radicals that results in the loss of the ability of neurons to produce dopamine.

But even that is not the whole answer. The brain is normally able to use coenzyme Q10, which is very abundant in brain, and other antioxidants to destroy free radicals before they damage brain neurons. Somehow in Parkinson’s patients free radical production and antioxidant production have gotten out of balance.

Advocates of the theory that statins may decrease the risk of Parkinson’s, point out that statins decrease oxidative damage. So if a person was predisposed to developing Parkinson’s and oxidative damage is a major cause of Parkinson’s, it is theoretically possible that statins could slow the progression to Parkinson’s while they were taking the drug. Of course, once they stopped taking the drug the oxidative damage to dopamine-producing neurons would resume and Parkinson’s would eventually develop.

In this model- Let’s call it Model A:

1) Oxidative damage of dopamine-producing neurons was caused by some unspecified external agent.

2) Statins protected the neurons from oxidative damage while they were being used.

3) Once the statin drugs were discontinued oxidative damage resumed and the risk of developing Parkinson’s increased.

This is the model favored by the authors and repeated in all of the headlines you saw.

Could Statins Increase The Risk Of Parkinson’s?

Statins also interfere with the synthesis of cholesterol and coenzyme Q10, and these are both absolutely essential for brain function. Let’s start with cholesterol:

20% of the body’s membrane cholesterol is found in the myelin sheath that coats the brain’s neurons (You can think of the myelin sheath as analogous to the plastic coating that insulates an electrical wire).

Cholesterol can’t cross the blood-brain barrier, which means that the brain cannot utilize cholesterol from the bloodstream . It has to make its own cholesterol.

As for coenzyme Q10:

It is not only a powerful antioxidant. It is also absolutely essential for cellular energy production.

The brain has tremendous energy requirements. The brain accounts for 20% of the energy utilization of our body. Neurons burn 2 times more energy than other cells in our body.

For both of these reasons, many experts have cautioned that statin drugs have the potential to cause neurodegenerative diseases such as Parkinson’s. In this model – Lets call it model B:

1) The statin drugs themselves are damaging the dopamine-producing neurons by inhibiting cholesterol and coenzyme Q10 synthesis in the brain.

2) The antioxidant effects of the statin drugs were masking the damage caused by the statins while the drugs were being used.

3) Once the statin drugs were discontinued the underlying damage was unmasked and the patients quickly developed Parkinson’s.

What Did The Study Actually Show?

The study (Lee et al, Neurology, 81: 410-416, 2013) looked at 43,810 statin users on the island of Taiwan. The Taiwanese Health System keeps extensive records of prescription use and health conditions of everyone on the island. It also requires that statin use be discontinued as soon as the patient reach their target of < 100 mg/dL LDL cholesterol, so they had the perfect population base to study what happens when you discontinue statin therapy.

The results were:

The patients who discontinued statin therapy were 42% less likely to develop Parkinson’s that those who continued on statin therapy. That result is consistent with both models A & B.

The increased risk of developing Parkinson’s when the drug was discontinued was only seen for the statin drugs like simvastatin and atorvastatin that are able to cross the blood brain barrier. That result is actually a bit more consistent with model B (Remember that the brain has to be able to make its own cholesterol and statins block cholesterol production).

When the study compared people using statin drugs to those not using statin drugs there was no significant difference in the prevalence of Parkinson’s – even for those statin drugs that cross the blood brain barrier. That means that merely being on a statin drug did not influence the risk of developing Parkinson’s. It was only when patients were on statin drugs for a period of time and were subsequently taken off statins that the risk of developing Parkinson’s was affected – and the effect was to increase risk! In the context of the first two findings, that result is also a bit more consistent with model B.

The Bottom Line:

If I were writing one of those medical blogs, I would have probably have gone with the party line and told you that statins decrease your risk of developing Parkinson’s. And if I were one of those health bloggers who never let the facts get in the way of a good story, I’d probably be scaring you with headlines saying that statins increase your risk of Parkinson’s.

But, I’m a scientist. I actually read the article, and I tell it to you like it is. Here’s your bottom line.

1) Ignore the headlines. The study they are talking about can’t distinguish between statins increasing or decreasing the risk of Parkinson’s. Don’t let anyone tell you that reducing the risk of Parkinson’s is a side benefit of statin therapy. That simply has not been proven.

2) The study does clearly show that discontinuing the statin drugs simvastatin and atorvastatin is associated with increased risk of developing Parkinson’s. That’s a big red flag for me, because 53% of patients discontinue statin therapy because of side effects, cost or other reasons.

3) However, statin drugs do save lives, especially for people who have already had a heart attack, so talk with your doctor about the benefits and risks of statin drugs, and which statin drugs are best for you.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Comments (8)

Angela

My husband has been on statins for more years than I can remember. His health has deteriorated greatly over the last 5 years and he has just been diagnosed with Parkinsons Disease. He has stopped the statins 3 weeks ago and there has been an improvement in his disposition and mental capacity. he has stopped hallucination/hearing things and and is carrying himself more balanced. He is happier in himself and not the grumpy old man he had become. He is smiling brightly. His slight tremor has now virtually disappeared. He is still very stiff. I believed it was the statins that were making him ill and now am more convinced of it than ever. It was because of what I could see that I looked for evidence on the www. There was certainly no case of ceasing the statins causing the Parkinsons.

Dr. Steve Chaney

Dear Angela,
Sometimes I am too subtle for my own good. I was raising the hypothesis that statins could cause neurological damage that increased the risk of Parkinsons, but that the neurological damage was masked by the anti-inflammatory effects of statins. Of course, once someone has been on the statins long enough it may no longer be possible to mask the symptoms. That is just a hypothesis at this point, but it would explain your husband’s situation.
Dr. Chaney

Rene Cote

After having an operation (2 stents), I received a prescription for Statins (Crestor).

After 2 days, I started to having pain while working, back pain also, and after 5 days I could hardly walk correctly. My doctor told me I had to excercise more.
After reading side effects on internet, I talk about it with my neighbor whose a phamacist. She told me to stop the statin treatment immediatly. After 3 days, I was back to normal.

My father who was taking statins for 5 years was diagnosed Alzeimer. He could hardly move and was confused once in a while.
My mother and I decided to stop my father’s statin treatment.
After 2 weeks, my father started suddendly to walk with no help and was much much less confused. After a visit to his doctor, the Alzeimer diagnostic was removed, and replaced with a Parkinson diagnostic, because he was shajing a bit from his right hand.

My non-scientific observation is that after being attacked by statins, their must be a period for muscles to get completly back to normal.

I am sorry but I think you don’t follow your own recommandations: where is it proven that “statin drugs do save lives”?

Dr. Steve Chaney

In clinical studies with patients who have already had one heart attack or otherwise have serious heart disease, statins significantly decrease the risk of a second heart attack. That has been shown in numerous clinical trials. As I pointed out, it has not been possible to prove that statins reduce heart attack risk significantly in people who have not had a heart attack. And the kind of side effects that you have described are real, and can be quite serious. This aspect of statin therapy has often been downplayed in the medical community.

Since oxidative stress of the dopamine producing brain cells appears to be the most likely cause of Parkinson’s, and since statins can cause or maybe protect against it, it would seem a more logical approach to prevention would be to take CoQ10 and other fat soluble antioxidants like Vitamin E and R-Alpha Lipoic Acid. This offers the best defense along with a good diet and exercise while avoiding a whole host of statin “side effects” aka unwanted direct effects, which are approaching 300 now.

I am not convinced that statins have cardioprotective effects in secondary prevention. The original 4S study showed a 0.8%/year absolute risk reduction in the simvastatin group relative to placebo and that was in a cherry picked population of 8888 men screened from 21,000 men with prior heart attacks. So why were over 12,000 men rejected from this study.?Why was the study population so large? Because the researchers knew going in that the effects of this drug would be minimal, therefore to achieve “statistical significance” they had to rig the study with large numbers of cherry picked men. There was no difference in strokes nor MI’s in either group. Studies of women with coronary disease have shown no benefit with statins in primary ore secondary prevention.

The absolute risk reduction in secondary prevention is so ridiculously miniscule that the long term risks of CHF, Type II diabetes, muscle and joint pain, cataracts, peripheral neuropathy, dementia, etc etc that I see in my patients very frequently make the use of these expensive drugs simply unacceptable

This is a scam of unbelievable proportions maiming and killing millions of people around the world all in the name of “cholesterol reduction” which has no effect on atherosclerosis.

I have directed a cardiopulmonary rehab program for the last 42 years and I see first hand the damage statins do as well as patients who have been on them for years and have another cardiac event due to progression of disease.. That is also why they have no effect on primary prevention. They Lipid Hypothesis of atherosclerosis has been dis proven and should discarded.

I am going to stop Atorvastatin 20 which my wife , a pt of CKD on hemodialysis has been taking for last 10years and also a pt of PD on Levodopa/ carbidopa for last 3 years, and monitor the for 10-20 days whether PD symptoms improve.

Dr. Steve Chaney

I always recommend checking with your physician first before going off medications. I report on clinical studies, which describe what happens for most people. However, each of us are unique and only our physicians know the pluses and minuses about changing medications for us as individuals. Tell you physician your concerns about PD and enlist their help in monitoring how your wife responds to going off or reducing Atorvastatin.

A Sleeping position that has your head tilted puts pressure on your spinal cord and will cause headaches. I’ve seen it happen hundreds of times, and the reasoning is so logical it’s easy to understand.

Your spinal cord runs from your brain, through each of your vertebrae, down your arms and legs. Nerves pass out of the vertebrae and go to every cell in your body, including each of your organs. When you are sleeping it is important to keep your head, neck, and spine in a horizontal plane so you aren’t straining the muscles that insert into your vertebrae.

The graphic above is a close-up of your skull and the cervical (neck) vertebrae. Your nerves are shown in yellow, and your artery is shown in red. Consider what happens if you hold your head to one side for hours. You can notice that the nerves and artery will likely be press upon. Also, since your spinal cord comes down the inside of the vertebrae, it will also be impinged.

In 2004 the Archives of Internal Medicine published an article stating that 1 out of 13 people have morning headaches. It’s interesting to note that the article never mentions the spinal cord being impinged by the vertebrae. That’s a major oversight!

Muscles merge into tendons, and the tendons insert into the bone. As you stayed in the tilted position for hours, the muscles actually shortened to the new length. Then you try to turn over, but the short muscles are holding your cervical vertebrae tightly, and they can’t lengthen.

The weight of your head pulls on the vertebrae, putting even more pressure on your spinal cord and nerves. Plus, the tight muscles are pulling on the bones, causing pain on the bone.

Your Pillow is Involved in Your Sleeping Position and the Causes of Headaches

The analogy I always use is; just as pulling your hair hurts your scalp, the muscle pulling on the tendons hurts the bone where it inserts. In this case it is your neck muscles putting a strain on your cervical bones. For example, if you sleep on your left side and your pillow is too thick, your head will be tilted up toward the ceiling. This position tightens the muscles on the right side of your neck.

Dozing off while sitting in a car waiting for someone to arrive, or while working for hours at your desk can also cause headaches. The pictures above show a strain on the neck when you fall asleep without any support on your neck. Both of these people will wake up with a headache, and with stiffness in their neck.

The best sleeping position to prevent headaches is to have your pillow adjusted so your head, neck, and spine are in a horizontal line. Play with your pillows, putting two thin pillows into one case if necessary. If your pillow is too thick try to open up a corner and pull out some of the stuffing.

Sleeping on Your Back & Stomach

If you sleep on your back and have your head on the mattress, your spine is straight. All you need is a little neck pillow for support, and a pillow under your knees.

Stomach sleeping is the worst sleeping position for not only headaches, but so many other aches and pains. It’s a tough habit to break, but it can be done. This sleeping position deserves its own blog, which I will do in the future.

Treating the Muscles That Cause Headaches

All of the muscles that originate or insert into your cervical vertebrae, and many that insert into your shoulder and upper back, need to be treated. The treatments are all taught in Treat Yourself to Pain Free Living, in the neck and shoulder chapters. Here is one treatment that will help you get relief.

Take either a tennis ball or the Perfect Ball (which really is Perfect because it has a solid center and soft outside) and press into your shoulder as shown. You are treating a muscle called Levator Scapulae which pulls your cervical vertebrae out of alignment when it is tight.

Hold the press for about 30 seconds, release, and then press again.

Your pillow is a key to neck pain and headaches caused by your sleeping position. It’s worth the time and energy to investigate how you sleep and correct your pillow. I believe this blog will help you find the solution and will insure you have restful sleep each night.

Wishing you well,

Julie Donnelly

About The Author

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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The statements in these articles have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease. Any Health Care changes should be made only after consulting with your Doctor and licensed Health Care Advisor.

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